Category: Avian

Bird X-Rays

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The first series of radiographs are before we had our digital radiography. As you scroll down and come to the rad’s taken by our digital machine you will see the increase in quality.

This first x-ray is from a normal cockatoo that is laying on its side, with the head towards the right. To see a diagram that labels these structures click here, then return for our x-ray tour of birds.

This is another normal cockatoo, this time it is laying on its back. The important organs have been labeled. Note the hourglass appearance of how the heart and liver connect.

These first two x-rays show a bird that has an abdomen filled with fluid. You cannot identify individual organs when the fluid is this extensive. Unfortunately, this is a serious condition.

This is an x-ray of a bird with an enlarged liver. The hourglass appearance between the heart and liver is not present.

This patient has lead toxicity (click here to learn more about lead toxicity). The arrow points to lead particles in the gizzard (stomach). Do you see the fractured leg also? The next x-ray shows the lead and fracture from a different view.

This same bird is now laying on its back, and emphasizes the importance of analyzing two views of an x-ray. The fracture (arrow) in the tibiotarsal (shin) bone is more apparent now. The other arrow points to the lead particles in the gizzard. Now go back and see if you can find the fracture in the view above (hint-it is in the leg to the left). This type of fracture can be handled with a splint.

Here is another bird with lead particles in the gizzard. You know how to recognize it now without an arrow.

The arrow is pointing to a metallic object that is in the bone marrow of the femur (thigh bone). Can you guess what this object is? The next x-ray shows you a side view of this object.


This is called an intraosseus (IO) catheter. It is used to give fluids, especially during an emergency. Birds have very thin walled veins and sometimes they do not hold up when we need to administer fluids. The IO catheter remedies this problem

The following radiographs are from our new digital radiography machine. You can click on them to enlarge.

Egg bound

Birdrad- egg

Fish hook in crop

Birdrad- fishook


Barium in crop


BB in skull


Hawk with BB’s in wing


Detail of digital radiography in a normal bird



Fractured tibiotarsal (shin) bone

Pelican Fx

Fish hook in gizzard (ventriculus)


Heron neck


Repair of fractured ulna in red tailed hawk. The metal object is an IM (intramdeullary) pin. The fuzziness around the pin is normal healing bone, called callus


Egg bound bird with egg almost out (in the cloaca)


Fracture repair using external pins




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Proventricular Dilatation Syndrome (PDS)

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Proventricular Dilatation Syndrome (PDS) , also known as Macaw Wasting Disease (it was first seen in macaws), is a devastating disease of mostly young psittacines. The proventriculus is the chamber of the digestive tract just in front of the ventriculus (gizzard). When it dilates there is an inability of the stomach to digest food. It can be a problem in any psittacine, but is found most commonly in macaws and cockatoos.


A virus is the most likely cause.


Birds that have this problem are weak, have lost weight, and can have difficulty perching. Many of them will regurgitate and pass undigested seeds in their droppings.

Regurgitation of a mucous like fluid is one of the classic signs of PDS. There might be seeds adhered to the mouth and feathers around the face.


Young cockatoos and macaws that have symptoms of this disease warrant further diagnostic tests. Other diseases can mimic PDS, so it is important to follow a thorough diagnostic process. Baby birds and those with infections, cancer or toxicities can also have a dilated proventriculus. Sometimes a biopsy of the crop or proventriculus is needed to confirm the diagnosis.

X-rays are a significant aid in making this diagnosis. The chambers of the stomach will show enlargement, which can be outlined with barium. Barium allows us to see the structures of the digestive tract more clearly. It also lets us know if the digestive tract is normal by assessing how long it takes for the barium to pass through to the end.

To understand how we perform a radiographic analysis of this problem it is important to understand the radiographic anatomy of a bird:

This is a normal x-ray of a bird laying on its right side. The head is towards the left. The diagram below explains the structures.

AS- air sac

PV- proventriculus

Vent- ventriculus (gizzard)

S- spleen

H- heart

This bird has PDS. The arrows circle the hugely dilated proventriculus.

We frequently give barium to help in outlining the digestive tract and to look for causes of the dilated proventriculus other than PDS.

In this x-ray the barium filled crop is on the far left (arrow on far left), there is barium in the esophagus (arrow in middle) and the ventriculus has barium in it (arrow on far right). The dilated proventriculus, without any barium in it, can be seen just to the left of the ventriculus.


PDS carries a poor prognosis. Medication to minimize vomiting and supportive care with fluids, antibiotics, and feeding small amounts of food at each meal might be helpful temporarily.

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Lead Toxicity

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Lead is a heavy metal and can easily cause a toxicity (called plumbism). Other heavy metals, notably zinc, can also cause toxicity.


Birds are sometimes drawn to shiny objects, hence they will eat metallic objects that can contain lead. Birds are natural chewers and will chew cage bars and painted walls. In older homes there are sometimes layers of paint below the surface layer that contain lead. Lead particles can build up on the ventriculus (gizzard) and become toxic if in large enough quantity.

Lead is a heavy metal that is poorly absorbed by the intestines. Unfortunately, only a small amount is needed to cause problems. It eventually gets distributed to all body tissues, with particular emphasis on the digestive system, the red blood cells, the bone marrow, the liver and the nervous system.

Sources of lead could include; old paint, old cages, solder, stained glass, curtain weights, foil, fishing weights, batteries, linoleum, plaster, and putty.


Symptoms depend on how much lead is ingested over how long a period of time. The disease is sometimes broken down into acute lead toxicity and chronic lead toxicity.

In the acute version birds might be weak, depressed, produce abnormal droppings, and vomit. Neurologic signs could include walking in circles, twitching, incoordination and even convulsions.

Chronically infected birds can have similar symptoms to acute toxicity. In addition, they might lose weight, be partially or fully paralyzed, and even blind.



In some lead infected birds there is a history of recent chewing of paint on the walls. In some cases the owners did not suspect any exposure to lead.

Physical Exam

The physical exam may or may not reveal significant abnormalities. It all depends on how much lead has been ingested over how long a period of time.

This bird has lead toxicity. It chewed the paint on the floor after the owner did some remodeling in an old home. He is alert and eating well but cannot walk well on his back legs.

Diagnostic Tests

A blood panel might be useful in this disease. In some birds we might see anemia or evidence of liver disease. When we suspect lead toxicity we can run a lead level on the blood.

A blood lead level gives us a more accurate indication if lead toxicity is present

This is from the bird above. His lead level is 0.5 parts per million, far above the normal range of less than 0.06

Some brids can have a zinc toxicity also.

One of the most consistent ways to diagnose lead toxicity is with an x-ray. Lead is a heavy metal and will show up vividly on a radiograph, usually in the ventriculus (gizzard).

This radiograph is also from the above bird. It has normal grit in the gizzard, but if you look closely some of the grit looks brighter than normal. The brighter objects are lead particles, not grit.


Birds that are weak, losing weight, or not eating need supportive care. This consists of fluids and supplemental feeding. We will frequently hospitalize them until they regain their strength. If they are having seizures we can put them on anticonvulsant medication.

It is important to try to remove the lead from the ventriculus. Treatment with lubricating agents or even peanut butter will help pull the lead out of the gizzard to be passed in the droppings. On rare occasions, especially if the lead particles in the ventriculus are too large to pass, we will perform surgery to remove them.

Once your bird is stable and we have attempted to remove the lead from its ventriculus we use a class of medications called chelating agents. Their job is to go into the organs, especially the bone, where the lead has accumulated and counteract its affects. It can take several courses of treatment to completely treat your bird. These medications are not without risk, so they are used intermittently to give your bird a rest period in between doses.

We will treat until the lead level in the blood test is back to normal and there is no more radiographic evidence of lead in the ventriculus.


It is the nature of birds to be chewers and put metallic objects in their mouth. Minimizing their exposure to lead containing objects is an obvious way to prevent this problem. Also, feeding them a balanced diet (not just seed) will help keep them from looking for nutrients they need and are not receiving in their diets.

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Egg Binding

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Egg binding is a problem that can occur in almost any bird, but is more common in the smaller female birds. Canaries, lovebirds, cockatiels, budgies (parakeets) and finches are the commonly affected breeds. Egg binding can be a serious problem, and is considered an emergency, requiring delicate and professional care. Unfortunately, some birds can succumb in spite of this care.

We don’t see egg binding in larger birds like this chicken very often, it at all

Birds are notoriously good at hiding symptoms of a serious problem until it is too late for treatment. It behooves you to pay special attention to your birds habits, and bring it in for an exam by one of our doctors at the first sign of any problem, no matter how minor it seems.

We like to see our birds come in like this healthy African Grey perching on Emily, that is in for a routine examination

Too often they come in sick like this bird, and in need of emergency treatment

The prognosis is not good when they are this ill

Sometimes they are ill because the egg is blocking waste products from being excreted. This might show up as an elevated Uric Acid on some ill birds. 

Graphic photos on this page. 


Infection, trauma to the reproductive tract, inadequate nesting area, excessive egg laying, obesity, and nutritional problems are some of the factors involved with this problem. Those birds on all seed diets, or those with an inadequate calcium intake, are particularly prone. An egg that is too soft can also cause the problem. Some birds are just prone to the problem, and even environmental factors like hypothermia can be involved. Determining the exact cause can be difficult.

We can sometimes get a feel for a bird that might have a problem laying eggs when we take a radiograph. The first one shows good density in the bones of the forearm and wrist of a bird. In the second one you can see there is less density, and sure enough, this bird was egg bound.

These bones have more mineral density, as evidenced by their whiter appearance. This means there is adequate calcium reserves. 

The same area of a smaller bird shows less mineral density. 

  This is the full radiograph of the bird above showing that indeed there is an egg in it. 


Birds that have this problem might exhibit depression, labored breathing, straining, abdominal distention, lack of droppings, whitish droppings only, fluffed appearance, and poor appetite. There might even be a broken bone due to inadequate calcium. These are also the symptoms of other avian diseases. Pressure from a stuck egg can even interfere with nerve function to the legs. Sometimes the only symptom is your bird sitting at the bottom of the cage. Unfortunately, the only symptom in some cases is a dead bird found at the bottom of the cage.


Even a bird that is eating can have serious illness


In many egg bound birds there is a history of recent egg laying. Some birds exhibit sexual behavior and even build nests. During physical examination of a bird with a distended abdomen an egg can sometimes be palpated. There are other causes besides egg binding in sick birds with distended abdomens, so it is important to follow a thorough diagnostic process.

Egg bound birds are very ill, and need to be handled gently so as not to stress them to the point that they succumb to this problem.

Our examination is rapid and gentle, and once we determine the problem they are immediately put into a warm room since they are very susceptible to hypothermia

We wrap them in a towel for the exam, and do not use gloves. This towel gives them warmth and comfort, and we can perform the exam with our bare hands to feel for subtle problems while our patient is wrapped in a comfortable towel. 

In most cases our doctor can make a diagnosis of a probable egg bound bird on palpation of the abdomen. Technically, their abdomen is called a coelomic cavity in birds, since they have no diaphragm to separate the chest from the abdomen, and it is all one cavity.

X-rays are a significant aid in making this diagnosis, but only if a bird is strong enough. Eggs shells have a high level of calcium, so depending on how well they are developed, might show up vividly on an x-ray. Some eggs are poorly calcified and do not show up well on a radiograph.

It’s not difficult to see the egg on this budgie that is laying on its back

This is the egg from the bird above. It looks tiny in this hand, but not so tiny for a bird this size as you can see from the radiograph above!


Egg bound birds are very ill and require emergency care. Many are hypothermic and require immediate warming. They can be toxic from the inability to eliminate waste products and dehydrated from poor appetites and weakness, so warm fluids are also administered. If the bird is in shock we will give these fluids via an intraosseus catheter. Calcium is also administered to aid in muscle contractions and hopefully expulsion of the egg on its own. Medications to stimulate the uterus to contract are also used.

Whether or not they help depends on the cause of the problem. In most cases, this conservative approach works, so we try this first.

Some are so ill that they need life-saving 100% oxygen in addition to supplemental warmth

If medical therapy does not work we attempt to help in the removal of the stuck egg. Once the bird is more stable we can sometimes gently expel the egg with liberal lubrication and digital pressure. If the egg is adhered to the uterus digital pressure might not work. Inserting a needle with a syringe attached directly into the egg allows us to collapse the egg and make expulsion easier.

Sometimes the medical therapy works to a certain point and the egg starts coming out. This one did, still in its reproductive membrane.

This bird is traumatizing its reproductive organs, so this is treated as an emergency

After warming it up and stabilizing with warm fluids, it was immediately sedated and examine and cleanses

Gentle manipulation, without tearing any membranes, allowed us to slowly extrude the egg

Out it came, ready to be made into an omelette !

Sometimes they don’t come out this easy, and we need to get them out. After stabilizing and anesthesia we use a speculum and high intensity light to assess the situation.

These are high risk patients, and are closely monitored while under anesthesia. Anesthesia is important to us in veterinary medicine, and you can learn much more about it form our anesthesia page

This female is being examined with a lubricated speculum to determine the exact nature of her problem. We can deflate the egg by passing the needle through the speculum. On the left you can see the high intensity cool light that allows greater visualization.

Birds need special attention and care, and after any medical or surgical treatment they are watched carefully by our staff


There are factors involved with this problem that we have no control over. Factors we can control are good nutrition, a clean environment, spaying birds that are predisposed to egg binding or are excessive egg layers, minimizing obesity and stimulating exercise.

Careful daily observation of your pets daily habits will help you recognize the early symptoms of this disease. No matter what the problem, any time your pet bird shows any symptoms of a disease, no matter how subtle, it is considered significant and requires immediate veterinary care. This is because birds are masters at hiding illness, and we are all too often presented with sick birds in advanced stages of disease. Our ability to return these birds to normal health is diminished because proper care has not been given early on in the disease process where it is most beneficial.

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Scaley Face Mites

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Birds are occasionally infected with a mite called Knemidicoptes (if you want to make an effort at pronouncing this word the K is silent). We usually encounter this problem in parakeets (Budgies) at our hospital. This parasite causes extensive crusting and hair loss on the face and vent.  Fortunately, it is readily treatable.


Scaley face disease is caused by a mite called Knemidicoptes that is spread from bird to bird by contact. Some birds acquire this parasite while young and do not develop symptoms until they are young adults.


This disease is diagnosed by the character of the lesions and the fact that it has occurred in a Budgie. Microscopic examination by a skin scraping will reveal the mite.

This bird has the telltale lesions of scaley face mites. There is crusting on the neck and face, and a honeycombed appearance to the beak. This is a severe case. In addition, this bird has a growth on its beak.

Lesions also occur in other areas, most noticeably in the vent and on the feet


Years ago the only treatment we had was an ointment that was used to treat pubic lice in people. It was messy and had to be applied daily, but it usually worked. Now we use the drug Ivermectin, given every week or two until the problem is gone, usually within 3-4 weeks.

This is the same bird as above 10 days after its first Ivermectin treatment. We removed the growth on its head a few days before this using the laser. This is the only way to do this type of surgery in our hospital due to its tremendous ability to control bleeding, a critical point in an animal this small that only has a few drops of blood in its cardiovascular system. 

Here he is 2 weeks after his second treatment. He is almost completely healed and feeling a million times better. Hard to believe it’s the same bird.

He was brought into our clinic and dropped off as part of our wildlife program since he was a stray and was found by one of our clients. He has a great personality, and once we got him looking like this we had no problem finding him a home (with a girlfriend).

The laser has revolutionized surgery on small animals in our hospital. If you want to see a laser surgery on another bird, click here.

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